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AbstractBackground Rapid eye movement sleep behavior disorder (RBD) has close relationship with Parkinson’s disease (PD), and even was regarded as the most reliable hallmark of prodromal PD. RBD might have similar changes in neuroimaging and gut dysbiosis to PD, but the relationship between RBD and PD in gut microbial alteration is rarely studied. In this study, we aimed to investigate whether there are the consistent changes between RBD and PD in gut microbiota, and find some specific biomarkers in RBD that might indicate phenoconversion to PD. Results This case-control study assessed microbiota of fecal samples from 35 idiopathic RBD (iRBD), 30de novoPD with RBD, 64 PD without RBD and 60 normal controls (NCs) by 16S ribosomal RNA amplicon sequencing (16S rRNA) and quantitative real-time PCR (qPCR). Alpha-diversity showed no remarkable difference and beta-diversity showed significant differences based on the unweighted (R = 0.035,P = 0.037) and weighted (R = 0.0045,P = 0.008) UniFrac analysis among four groups. Enterotype distribution showedRuminococcuswas dominant in iRBD, PD with RBD and PD without RBD, while NC wasBacteroides-dominant. 7 genera (4 increased:Aerococcus, Eubacterium,GordonibacterandStenotrophomonas, 3 decreased:Butyricicoccus, FaecalibacteriumandHaemophilus) were consistently changed in iRBD and PD with RBD. Among them, 4 genera (Aerococcus, Eubacterium,Butyricicoccus, Faecalibacterium) remained distinctive in the comparison between PD with RBD and PD without RBD.Butyricicoccus and Faecalibacteriumwere found negatively correlated with the severity of RBD, andStenotrophomonaswas found positively related to RBD disease duration. Functional analysis showed iRBD had similarly increased staurosporine biosynthesis to PD with RBD. Conclusions RBD has similar gut microbial changes to PD. DecreasedButyricicoccusandFaecalibacteriummight be specific to RBD, and also potential hallmark of phenoconversion of RBD to PD.
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